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Need Advice About Serious Cousin Issue (Very Long)

Hi Everyone!  So, this is a very long, complicated story, but it only continues to get worse as the years go on, so I was hoping to get some wisdom from you ladies about this awful situation.

Basically, here's what's going on.  My cousin "D" is 24 years old.  When she was 20, she was in a very serious car accident.  She got distracted, drove off the road, the car flew down an embankment, hit a utility pole, split in half, then flipped over.  D was air-lifted to the hospital after hanging upside-down from her seatbelt for 30 minutes while firemen cut her out of the car.  Her injuries included a serious blow to the head (which resulted in permanent Traumatic Brain Injury), a fractured skull, 10 broken ribs which punctured her lungs, collapsed lungs, fractured pelvis, ruptured spleen, fractured spine, internal bleeding, etc.  D was in a coma for 3 weeks and then woke up:  a medical miracle by account of all of the doctors.  They told us that she'd die.

So, after all of these injuries, D was in the hospital for 8 months.  She had to learn how to walk, talk, read, write, pee, eat, EVERYTHING all over again.  She now functions pretty well...except for her behavior.  She has serious brain injuries, and the doctors all say that she will pretty much remain in the mental stage of a rebellious 13 year old for the rest of her life.

She had to drop out of college because she couldn't retain too much new information (memory issues).  She can't work even the simplest of jobs because of her memory issues and because she has very limited fine motor skills.  Because of this, she cannot live the life of a normal 24 year old...she can't drink (because of all of her medication), she'll never be able to drive again, she has pretty much been staying home for the past 4 years.  She has been very depressed because of this and has been in and out of mental hospitals over 10 times in the last 4 years.  She has become very angry and violent.  She hits my aunt and curses at everyone.

She is also very sexually inappropriate.  She runs away all of the time.  She meets random, unstable people either on the bus or in mental hospitals and they become the "love of my life".  She was caught in bed with a 50-something year old married man that she met at the hospital.  She had a period of lesbianism with a 40-something year old woman that she met at the hospital.  She dated a 30-something year old paraplegic man for a while.  Now she's dating a guy who she met on the bus (who she's known for a month) and is already in love with him. She's even begun stealing from my aunt and uncle so that she can get things for her "new house" with this guy!  They had to put locks on all of the doors of the house!

Because she's over 21, you cannot force her to do anything.  Her doctor refuses to declare her incompetent.  He says that "She can make decisions; just not good ones."  Clearly, she's not totally competent.  My aunt has been assigned by the court to be the sole manager of D's social security money.

I know this is such a long story, and I'm sorry...but has anyone dealt with something like this?  It's been going on so long, and my poor aunt and uncle are at their wit's end.  It's killing me to watch this unfold.  Any advice would be greatly appreciated.

Re: Need Advice About Serious Cousin Issue (Very Long)

  • Need to go to a different doctor- second opinion; maybe even a third opinion. But she needs to be declared incompetent- that's what she is. The dr who said she can make decisions just not good ones isn't doing her any favors by not letting her family give her the medical (and legal) protection she needs.
  • I am sorry that you and your family are going through this.  I have two TBI's (Tramatic Brain Injury) family members.  It is much of the same of what you describe - inappropriate comments, lack of long term memory, unable to obtain a job, ect. I think that your family would be wise to head the advice of the doctors when they say that she will be stuck in this phase.  As for how to cope with this, I would look into support groups in your area.  I think that each case is different, and broad advice or even advice what works for my family is probably not going to be the solution for yours. 

    BabyFruit Ticker
  • Her family needs to get a lawyer to get a guardianship/conservatorship over her; they need control over her funds and where she will live. She will not get better; and she likely has a normal life span. I am very sorry; but they need to have her birth control enforced, her living situation in hand, etc, and it sounds like they don't.


  • Yes, actually.  State and federal laws provide for the care and rehabiliation of citizens with brain trauma experienced before the age of 21.  Your cousin can and should be getting SI/SSD and involved with support services that meet her needs; including day hab, supported living, and casework services.

    I'm surprised your aunt and uncle haven't connected with a good developmentally disabled program.  I'm not talking about some state run facility with white walls and locks on the door. I am talking about high quality, non-profit agencies that offer a wide array of support from assigning a case-worker to check-in monthly at an apartment where she lives independently, to an apartment with weekly check-in and a roommate, to a group facility (like a big house in an up-scale neighborhood), to a group facility with 24-hr.on-site staff.  Its based on HER level of care and need.

    These non-profits connect people to apartment and jobs, help manage money and even plan/supervise group vacations to Disney and local beaches.  And yes, they struggle with issues of independence and sexuality and birth control and relationships.  For decades.

    I learned a lot about this from:

    It may not be in your geographical area, but it's a starting point for resources and information.  Good luck.

    My darling daughter just turned 4 years old.
  • It's one thing for your family to safeguard assets (so she can't steal from them) and to organize it so that family provided funding for her is not under her control.

    It's another to have her declared incompetent.  The doctors are right - she is capable of making decisions, bad ones, but her own decisions none the less.  If she manages to earn her own money, your family cannot take it from her no matter how good their intentions.  She cannot be prevented from having relationships, no matter how much your family might not approve.  It sucks but this is the life she gets, and SHE gets to live it.

    My cousin (male) is in a similar condition from a car accident.  He cannot hold down a job, he flies into terrifying rages at the drop of a hat, he makes really bad choices.  But this is HIS life.  Our family watches out for him as best we can, but we cannot take over for him.


  • I'm sorry that you are going through this.

    I'm a speech therapist and worked in a TBI Rehabilitation program for several years. The facility I worked at had a transitional living center, which helped individuals with brain injuries re-learn living skills again....we did everything from taking our patients to Target to practice shopping, finding things, counting money, interacting with strangers, to teaching them to drive again (if they were able), and even enrolling them in modified college courses. In fact, we had a TBI program in conjunction with the local junior college, to work with the patients and their issues in a modified environment. We worked extensively with the families and with the patient, though, to help re-train things like to how build a relationship, or what is/isn't appropriate, how to communicate, etc. . A lot of times that filter that a non-injured person has is gone in a TBI patient, and it can be hard for them to comprehend why their actions are wrong or dangerous to themselves.

    I think I'd look for a program like this in your cousin's area. We worked in conjunction with a neuropsych and OT and PT- it was a comprehensive program with everyone working together to rehabilitate the patient.

    I don't know if your cousin would qualify for a developmental disability program, since this is an acquired injury.

     Here are some links you may want to check out:

    These are just a few, but I am sure if you Googled it you could find more programs.

    Good luck to you! You can PM me if you have any questions that you think I may be able to help you with.

  • P.S. And ditto the PP- she should be seen by another doctor to get a second opinion. Also, is there any way your aunt could hire an adult companion, maybe for just a few hours a day, to take her shopping, to a class, social group, etc. and help her get out more and keep an eye on her?  Some of my old patients had a helper/companion for when they left...someone who was not a part of the family (sometimes the family dynamic contributes to the behavior). Just a thought!
  • Medical doctor, Psychiatrist, therapist...all these people can help with paperwork and long process to help get her help she needs. They need to pursue legal avenues for guardianship...from what you said she is not able to care for self financially, housing, medical issues. This is what a guardian is for.
  • I second what everyone here is saying.  There are two traumatic brain injury teens on our street, different accidents.  They have helpers who come to the home every day teach them things, care for them and take them on field trips.  The children also go to centers and learn every day skills.

    My brother is a drug addict and I can somewhat understand what your aunt and uncle are going through.  He has mental health problems and brain damage from all the drugs.  He steals from them and has stolen tens of thousands secretly from their retirement account.  My poor mother has to take him to all his appointments with doctors to make sure he goes and has to stay home with him at all times to make sure he is safe.  Its very hard on my family.

    Try to encourage them to get her good doctors who are willing to send your cousin to day treatment, rehab, psychiatrists who specialize in brain injuries and maybe some kind of help for your aunt.

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